Long term virological, immunological and mortality outcomes in a cohort of HIV-infected female sex workers treated with highly active antiretroviral therapy in Africa

BACKGROUND: Concerns have been raised that marginalised populations may not achieve adequate compliance to antiretroviral therapy. Our objective was to describe the long-term virological, immunological and mortality outcomes of providing highly active antiretroviral therapy (HAART) with strong adherence support to HIV-infected female sex workers (FSWs) in Burkina Faso and contrast outcomes with those obtained in a cohort of regular HIV-infected women. METHODS: Prospective study of FSWs and non-FSWs initiated on HAART between August 2004 and October 2007. Patients were followed monthly for drug adherence (interview and pill count), and at 6-monthly intervals for monitoring CD4 counts and HIV-1 plasma viral loads (PVLs) and clinical events. RESULTS: 95 women, including 47 FSWs, were followed for a median of 32 months (interquartile range [IQR], 20-41). At HAART initiation, the median CD4 count was 147 cells/μl (IQR, 79-183) and 144 cells/μl (100-197), and the mean PVLs were 4.94 log10 copies/ml (95% confidence interval [CI], 4.70-5.18) and 5.15 log10 copies/ml (4.97-5.33), in FSWs and non-FSWs, respectively. Four FSWs died during follow-up (mortality rate: 1.7 per 100 person-years) and none among other women. At 36 months, the median CD4 count increase was 230 cells/μl (IQR, 90-400) in FSWs vs. 284 cells/μl (193-420) in non-FSWs; PVL was undetectable in 81.8% (95% CI, 59.7-94.8) of FSWs vs. 100% (83.9-100) of non-FSWs; and high adherence to HAART (> 95% pills taken) was reported by 83.3% (95% CI, 67.2-93.6), 92.1% (95% CI, 78.6-98.3), and 100% (95% CI, 54.1-100) of FSWs at 6, 12, and 36 months after HAART initiation, respectively, with no statistical difference compared to the pattern observed among non-FSWs. CONCLUSIONS: Clinical and biological benefits of HAART can be maintained over the long-term among FSWs in Africa and could also lead to important public health benefits

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Le profil du personnel enseignant du primaire au Burkina Faso : construction d’une typologie par l’analyse des pratiques enseignantes et relation avec la formation initiale

Le programme Observation des pratiques enseignantes dans leur rapport avec les apprentissages des élèves (OPERA) a été mis en oeuvre au Burkina Faso de 2013 à 2015. Des analyses de pratiques enseignantes ont été faites sur la base d’observations de 90 enseignantes et enseignants de deuxième et sixième année du primaire lors d’une première phase et de 41 d’entre eux lors d’une seconde phase. L’analyse des données recueillies auprès des 41 enseignants observés au cours des deux phases ont permis d’établir deux types de profils : 1) des profils de représentations – « enseignement » ou « apprentissage » – du processus enseignement-apprentissage; 2) des profils de pratiques effectives révélant un profil relationnel positif, trois profils pédagogiques et trois profils didactiques. Après les avoir présentés, cet article propose une discussion sur ces profils en les mettant en lien avec les programmes de formation des enseignantes et enseignants. On constate qu’il n’existe pas de profil de pratiques pur ou définitif, le contexte amenant les enseignants à s’adapter. Néanmoins, le domaine didactique apparaît souvent moins investi que les deux autres par les enseignants, ce qui semble en phase avec l’orientation de leur formation, soit la pédagogie par objectifs.The program Observation of teacher practices in relation to pupil learning (OPERA research programme) was implemented in Burkina Faso from 2013 to 2015. Analyses of teaching practices in the first phase were based on the observations of 90 grade 2 and grade 6 primary school teachers and of a sub-sample of 41 teachers in the second phase. Two types of profiles emerged from the analysis of the data collected from the 41 teachers observed during both phases: 1) profiles of "teaching-centered" and "learning-centered" representations of the teaching-learning process; 2) actual teaching practice profiles revealing a positive relational profile, three pedagogical profiles and three didactical profiles. After presenting them, we discuss these profiles in relation to teacher education programs. It appears that there is no such thing as a pure or definitive profile of practice; teachers adapt according to the context. Nevertheless, the didactic domain seems often less invested than the other two; which reflects the orientation of the country’s teacher preparation programs, i.e., pedagogy by objectives.El programa Observación de prácticas educativas y su relación con los aprendizajes de los alumnos (OPERA) se implementó en Burkina Faso entre 2013 y 2015. Los análisis de la prácticas educativas fueron realizados sobre la base de observaciones de 90 maestros y maestras de segundo a sexto grado de primaria durante la primera fase y de 41 de ellos durante la segunda fase. El análisis de los datos recopilados entre los 41 maestros observado durante las dos fases no han permitido establecer dos tipos de perfil: 1) los perfiles de las representaciones de la «enseñanza» o del «aprendizaje» del proceso enseñanza-aprendizaje; 2) los perfiles de las prácticas efectivas que muestran un perfil relacional positivo, tres perfiles pedagógicos y tres perfiles didácticos, Después de ser presentados, este artículo propone una discusión sobre dichos perfiles relacionándolos con los programas de formación del magisterio. Se constata que no hay un perfil de prácticas puro o definitivo, el contexto conduce al maestro a adaptarse. Sin embargo, el campo didáctico aparece menos involucrado que los otros

Complementarities and synergies with intermittent renewable energy, related issues - Burkina Faso cases studies

Pumped Storage Plants (PSP) offer opportunities for better water mobilization and to unlock the development of hydropower in Burkina Faso. The revolution in photovoltaic energy, which has greatly improved reliability and production costs, has opened up major prospects for the energy development of Sahelian countries with a very large solar energy deposit that has remained fallow for the time being. The lower production cost of solar energy makes it more attractive to mobilize water in offshore (outside rivers) basins and reservoirs in areas where there are few underground water resources and where flat land limits the construction of dams. This paper will develop these perspectives for a country like Burkina and the Sahel in general where access to electricity is one of the lowest in the world which, paradoxically, have a very large solar deposit and insufficient water resource mobilization

Bilateral Tubal Pregnancy without Known Risk Factor

Spontaneous bilateral ectopic gestation is very rare. The authors report a case diagnosed and taken care of at Yalgado Ouedraogo Teaching Hospital, Ouagadougou. It was a 30-year-old patient with no known pathological history. She had presented at the obstetric emergencies with a state of hypovolemic shock by haemoperitoneum with digestive disorders, pelvic pain, vaginal bleeding, and a mention of delayed menstruation. The ultrasound coupled with the urinary immunological pregnancy test confirmed the diagnosis of ruptured ectopic pregnancy and a bilateral form was suspected. A laparotomy in emergency confirmed the diagnosis of bilateral ectopic gestation with a right ampullary unruptured pregnancy and a left isthmic ruptured gestation. A bilateral salpingectomy was performed and counseling was made for the use of medical help of procreation in case of future need of pregnancy

Changes in Woody Vegetation over 31 Years in Farmed Parkland of the Central Plateau, Burkina Faso

Farmed parklands of the Central Plateau, Burkina Faso, integrate native woody vegetation with managed cropland. However, sapling survival in the parklands is increasingly threatened. This study characterized woody vegetation abundance along a 2.7 km long transect in the Doulou Basin, Boulkiemdé Province, Central West Region, to assess changes in vegetation composition since 1984. In addition, a householder survey was conducted to gain insight into tree uses and preferences and residents’ knowledge of regulations. In total, 4999 individuals from 26 tree species were recorded, including 123 individuals (11 species) with stem DBH ≥ 5 cm, and 4876 individuals (21 species) with stem DBH < 5 cm. The three species with the highest importance value index provided fruit for sale or self-consumption. Tree abundance was associated with soil type and topography; highest abundance was on Lixisol soils along the lower transect. Soil degradation and preference changes among residents since 1984 may have influenced tree abundance. Certain beneficial species (e.g., Vitellaria paradoxa) have declined in abundance, and certain exotics (Azadirachta indica and Eucalyptus camaldulensis) have expanded in distribution. Respondents expressed strongest interest in three species, including V. paradoxa, that show high versatility. These results supported the recorded tree composition. The respondents generally understood forest conservation regulations. Dissemination of regreening technology and awareness promotion among residents is essential for sustainable tree use in farmed parklands